Digits Core Service for TBI Triage
How the Digits Core Service — a camera-only, device-agnostic hand-motor engine — can triage, analyze, and evaluate traumatic brain injury in the prehospital window, and why it is a direct fit for MATTER's Paratus Digital Health Accelerator non-dilutive TBI funding. Maps the program's requirements onto motor biomarkers Digits already computes.
The Paratus Digital Health Accelerator — MATTER’s hub in the BARDA Accelerator Network — is offering non-dilutive funding for digital tools that triage suspected traumatic brain injury (TBI) in the prehospital window, with limited access to imaging and lab equipment. Digits Core Service is a camera-only, device-agnostic motor-assessment engine. Motor function is one of the earliest and most measurable signals of acute neurological insult. This is a direct fit — the same hand-kinematics substrate that scores rehabilitation can flag a brain injury at the point of contact.
The Opportunity
Paratus is funding advanced development of digital tools for assessing TBI as a medical consequence of blast and other mass-casualty events. The brief is specific about the operating environment, and it maps almost one-to-one onto how Digits already works:
- Prehospital, equipment-poor. Solutions must work with limited or no access to CT/MRI imaging or lab assays — exactly the setting where a phone camera and 90 seconds is the entire instrument budget.
- Usable by non-specialists. Administrable by health care professionals, first responders, or self-administered by the patient within 24–72 hours of injury.
- Triage, not diagnosis. The goal is faster identification of acute TBI needing urgent care — a structured, defensible flag that routes the right people to imaging.
- Funding structure. $500K–$2M non-dilutive, at Software Prototype or Early Clinical stage, over a timeline of up to 24 months, with access to mission-aligned study sites for validation.
Why the Hand Is a TBI Biomarker
Fine motor control consumes a disproportionate share of motor cortex and depends on intact corticospinal tracts, cerebellar timing, and basal-ganglia sequencing. When a brain is injured, the hand is one of the first places it shows — which is why finger-tapping speed, movement timing, and bilateral symmetry are long-standing items in neurological and concussion exams (Halstead-Reitan, sideline assessment batteries). Digits turns those clinical observations into quantified, camera-derived signals:
- Bradykinesia & slowing. Reduced tapping frequency and longer time-to-completion track psychomotor slowing.
- Dysrhythmia & incoordination. Loss of cycle-to-cycle consistency and degraded sequence accuracy reflect disrupted motor timing.
- Asymmetry. A widening gap between dominant and non-dominant hand performance is a classic lateralizing sign of unilateral injury.
- Tremor & loss of smoothness. Involuntary oscillation and jerk in held postures and reaching movements.
- Range-of-motion deficits. Reduced or guarded ROM from weakness, neglect, or paresis.
What Digits Core Service Already Measures
None of this requires new sensing hardware. Digits Core Service runs MediaPipe hand tracking on a standard device camera and emits structured, clinically-graded metrics. The relevant TBI-screening signals are already in production for hand rehabilitation:
The finger-tapping engine alone yields clinically-correlated metrics:
- Sequences completedin 20s — the primary speed metric (correlated against clinical motor scoring at r = -0.65).
- Average frequency (taps/sec, r = 0.61) and time-to-10-sequences(r = 0.59) — psychomotor slowing.
- Sequence accuracy and cycle consistency (0–100) — sequencing and rhythm integrity.
- Touch precision from 3D fingertip distance — targeting and coordination.
Outputs come at two fidelities — clinical-grade for the record and patient-grade for the field — and the service already ingests both live capture and uploaded video, device-agnostically.
The Prehospital Triage Flow
A first responder or the patient opens the assessment on any phone or tablet. No login, no imaging, no calibration rig:
- 1. Capture (~60–90s). A guided ROM sweep plus a bilateral finger-tapping task, run once per hand, face and background stripped on-device.
- 2. Score. Digits Core Service computes the motor metrics above and a left-vs-right asymmetry index.
- 3. Flag. A traffic-light triage signal — paired with text and the underlying numbers, never color alone — green (within normal motor band), amber (re-test / observe), or red (motor deficit — escalate to imaging/urgent care).
- 4. Hand off. A structured record (CSV + interpreted results + the processed clip) travels with the patient for the receiving clinician — the same Digits Research Connect output path.
Requirement → Capability Fit
| Paratus / TBI requirement | Digits Core Service today |
|---|---|
| Works prehospital with no imaging or lab equipment | Single RGB camera; no CT/MRI, no peripherals, no lab |
| Self-administered or run by a first responder in 24–72h | Guided, gated 60–90s flow; voice-coached; no clinician needed |
| Device-agnostic, field-deployable | Runs on any phone/tablet/laptop camera; live or uploaded video |
| Fast triage signal that routes urgent cases | Traffic-light flag + structured metrics + bilateral asymmetry |
| Objective, reproducible motor measurement | Clinically-correlated tapping/ROM metrics; clinical-grade output tier |
| Validation-ready at study sites | DRC export (CSV + interpreted results + clip); myLaminin trial substrate |
What the Funding Would Build (≤24 months)
- A TBI-specific normative model. Age- and handedness-adjusted reference bands and a bilateral asymmetry index tuned for acute injury rather than chronic hand pathology.
- An acute-injury motor battery. Extend the existing ROM + tapping tasks with reaction-time and reach-and-hold (tremor / smoothness) tasks selected for sensitivity to mild TBI.
- Field-hardening. Offline / low-connectivity capture, robustness to poor lighting and motion, and a ruggedized responder UX on top of the device-agnostic core.
- Clinical validation. A prospective study at Paratus mission-aligned sites correlating Digits motor flags against confirmed TBI outcomes — the data foundation for an FDA pathway.
Digits is currently an investigational measurement tool and is not yet FDA-cleared for TBI triage; the funded work is precisely the validation and regulatory effort that closes that gap.
Why This Is Strategically Coherent
TBI triage is not a pivot — it is a second indication on the same engine. Digits Core Service is positioned as the clinical API layer for the hand: one validated measurement substrate, many surfaces. Hand rehabilitation and arthritis monitoring are the first indications; prehospital TBI motor-screening is the next. The intelligence, the validation, and the regulatory wrapper compound across all of them.
Paratus offers exactly what a measurement platform needs to add an indication responsibly: non-dilutive capital, clinical and regulatory mentorship, and access to study sites. It funds the validation that turns an existing, working motor engine into a defensible TBI triage tool — without diluting the company or distorting the roadmap.